And It Never Will Be...

On that dreaded comparative clinical effectiveness research clause that has surfaced in the most recent stimulus bill, I believe Steven Pearlstein of the Washington Post puts it best:

"This isn't Britain."

Freedom vs. Security

Brian Klepper of the Health Care Blog has posted a fine piece on a recent U.S. Appeals Court decision to overturn that made by a lower court, which would have forced public release of Medicare physician data.

There's lots of goods stuff in this post surrounding the privacy interests of physicians vs. the public benefit of increased cost and pricing transparency. Klepper concludes:

“My guess is that the Appeals Court’s decision for physician privacy at the expense of patient knowledge will be extremely short-lived, and end up being nothing but a minor negative footnote in the steady march toward better health care in America. Certainly, there is good evidence that some progressive health plans increasingly understand the value of using their data to drive better patient decisions, and to make physicians aware of their own performance.”

Although Klepper's conclusion is entirely what I would hope for, I'm much more skeptical. I'm inclined to believe that many more rulings of individual privacy over the public good will likely be made in the near term. And what will come of this? More of the same. But only time will tell…

Daschle & Reform

On the Daschle debacle, I think Ezra Klein puts it best:

Instant reaction: This is good for the cause of ethics in government. Senators and Congressmen who look forward to an executive branch appointment someday will now be much more wary of immense consulting gigs and highly paid speeches to industry stakeholders.

But this whole debacle has been very bad for health reform. Put aside Daschle's unique advantages -- his knowledge of the Senate, his relationships with legislators, his direct line to Obama. The administration will now spend time finding a new nominee, vetting him or her, waiting while they build trust and relationships in the administration and on the Hill, and so forth. I'd say the chances of health reform happening in 2009 -- and thus at all -- are lower now than a week ago. This also makes it more likely that the process is Congress-driven as opposed to White House driven.